​​How Are Early Childhood Irritability and Tantrums Related to Future Depression and Self-Harm?​

A study(opens in new tab/window) in the Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP), published by Elsevier, reports that children whose irritability did not improve during early childhood experienced higher levels of depression and self-harm as teenagers.  

Irritability and tantrums are normal during the toddler/preschool the preschool years and parents sometimes refer to this age group as the ‘terrible twos’ and ‘threenagers’.’For most children, irritability improves as they grow older. However, some children continue to struggle with irritability and behavioral outbursts as they grow older. Although previous research showed that irritability in later childhood increased the risk of future depression, it was not known whether irritability during early childhood is similarly important. Identifying a marker for increased risk earlier would give us greater opportunity for devising preventive interventions.   

This study is based on data from over 7,000 children who participated in the Millennium Cohort Study: a contemporary, nationally representative UK birth cohort. Parents answered questions about their child’s irritability at 3, 5, and 7 years, and teenagers reported depressive symptoms and self-harm at 14 years. This study found that children with irritability that did not decrease between the ages of 3 and 7 years experienced higher levels of depression and self-harm in adolescence, whereas irritability at 3 years only was not associated with later depression.   

Study author, Dr Ramya Srinivasan, a clinical research fellow in child and adolescent psychiatry at University College London says, “This study suggests that while some degree of irritability is part of normal child development, we can identify children who struggle with persistent irritability from as young as 5 years, thus providing an opportunity for prevention and early intervention”.  

She adds, “The findings emphasize the importance of early childhood for emotional development. Support for parents of young children has been reduced in many countries in recent years and was substantially disrupted by the Covid-19 pandemic. This is concerning and a possible missed opportunity.”   

Notes for editors 

The article is "​Changes in Early Childhood Irritability and Its Association With Depressive Symptoms and Self-Harm During Adolescence in a Nationally Representative United Kingdom Birth Cohort​," by ​Ramya Srinivasan, BMBCh, Eirini Flouri, PhD, Gemma Lewis, PhD, Francesca Solmi, PhD, Argyris Stringaris, MD, PhD, FRCPsych, Glyn Lewis, PhD​ (​https://doi.org/10.1016/j.jaac.2023.05.027(opens in new tab/window)​). It appears in ​Journal of the American Academy of Child & Adolescent Psychiatry​, volume ​63​ issue ​1​ (​January 2024​), published by Elsevier. 

Copies of this paper are available to credentialed journalists upon request; please contact ​Ramya Srinivasan, BMBCh​ at ​[email protected](opens in new tab/window) ​.  

About ​​JAACAP​​ 

Journal of the American Academy of Child and Adolescent Psychiatry(opens in new tab/window) (JAACAP) is the official publication of the American Academy of Child and Adolescent Psychiatry. JAACAP is the leading journal focusing exclusively on today's psychiatric research and treatment of the child and adolescent. Published twelve times per year, each issue is committed to its mission of advancing the science of pediatric mental health and promoting the care of youth and their families. 

The Journal's purpose is to advance research, clinical practice, and theory in child and adolescent psychiatry. It is interested in manuscripts from diverse viewpoints, including genetic, epidemiological, neurobiological, cognitive, behavioral, psychodynamic, social, cultural, and economic. Studies of diagnostic reliability and validity, psychotherapeutic and psychopharmacological treatment efficacy, and mental health services effectiveness are encouraged. The Journal also seeks to promote the well-being of children and families by publishing scholarly papers on such subjects as health policy, legislation, advocacy, culture and society, and service provision as they pertain to the mental health of children and families. 

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